Social support and stroke and coronary heart disease - The JPHC Study Cohorts II
Social support and stroke and coronary heart disease - The JPHC Study Cohorts II
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DOI：
10.1161/strokeaha.107.496695
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发表时间：
2008-03-01
期刊：
影响因子：
8.3
通讯作者：
Tsugane, Shoichiro
中科院分区：
文献类型：
--
作者：
Ikeda, Ai;Iso, Hiroyasu;Tsugane, Shoichiro
背景和目的——在西方国家进行的研究发现，社会支持与心血管结局（如心肌梗死后预后和卒中后功能恢复）之间存在密切关联。然而，在亚洲人群中，社会支持对同样结果的影响却知之甚少。在这项前瞻性队列研究中，我们试图研究社会支持对日本人冠心病和中风的发病率和死亡率的影响。方法：我们前瞻性地研究了44152名年龄在40至69岁之间的日本男性和女性的社会支持与冠心病和中风发病率和死亡率之间的关系，这些人以前没有诊断过癌症和心血管疾病。从基线问卷调查（1993 - 1994年）到2004年1月随访结束，共发生301例新诊断的冠心病、1057例中风、191例冠心病死亡和327例中风死亡。结果——在社会支持程度最高的群体与社会支持程度最低的群体中，卒中死亡率的多变量风险比和95% CI为1.45(1.00 - 2.10)，男性为1.59(1.01 - 2.51)，女性为1.25（0.63 - 2.46）。社会支持与中风发病率、冠心病发病率和死亡率无关。结论：低社会支持与男性中风死亡率增高有关。然而，社会支持与脑卒中发病率无相关性，提示社会支持对脑卒中预后的影响可能比预防脑卒中发病率更重要。
Background and Purpose - Studies conducted in Western countries have found a robust association between social support and cardiovascular outcomes ( eg, prognosis after myocardial infarction and functional recovery after stroke). However, less is known about the influence of social support on the same outcomes among Asian populations. In this prospective cohort study, we sought to examine the impact of social support on the incidence and mortality of coronary heart disease and stroke among the Japanese.Methods - We examined prospectively the association between social support and risk of coronary heart disease and stroke incidence and mortality within a cohort of 44 152 Japanese men and women aged 40 to 69 years, free of previous diagnosis of cancer and cardiovascular disease. A total of 301 cases of newly diagnosed coronary heart disease, 1057 strokes, 191 coronary heart disease deaths, and 327 stroke deaths occurred between the baseline questionnaire ( 1993 - 1994) and the end of follow-up in January 2004.Results - The multivariate hazard ratios and 95% CI for stroke mortality in the highest social support versus lowest social support group was 1.45 ( 1.00 to 2.10) overall, 1.59 ( 1.01 to 2.51) for men, and 1.25 ( 0.63 to 2.46) for women. Social support was not associated with stroke incidence or coronary heart disease incidence and mortality.Conclusions - Low social support was associated with higher risk of stroke mortality in men. However, social support was not associated with stroke incidence, suggesting social support may be more important in stroke prognosis than preventing incidence.